Your Child's Diabetes Health Care Team

What the Health Care Team Does

The diabetes health care team teaches families all about diabetes. It helps families create and use the child's treatment plan, also called the diabetes management plan.

The team adjusts insulin and other diabetes medications, develops meal plans, and makes physical activity recommendations to help control blood sugar levels.

All team members should take into account your child's schedule, skills, preferences, lifestyle, and growth and developmental needs. The team will also help you cope with the parenting challenges of having a child with a chronic illness and will help your child cope with his or her own set of challenges.

Keep in mind that you and your child are the captains of your diabetes health care team — all of the team activities center around helping you and your child manage diabetes. In many cases, the roles and responsibilities of the team members overlap. You should feel comfortable communicating with all of the team members because you'll be in contact with them often.

Doctors

A pediatric endocrinologist is a doctor who specializes in the diagnosis and treatment of children with diseases of the endocrine system, such as diabetes and growth disorders. But pediatricians, family practitioners, and other medical doctors also can treat kids with diabetes and manage their health care needs.

It's important to recognize that seeing a specialist like a pediatric endocrinologist doesn't replace the need for your child to continue to get general health care from a pediatrician or other primary care doctor.

You and your child should feel comfortable with the doctors you choose because your child's diabetes management plan is based on the doctor's prescribed treatment. Ask plenty of questions and make sure you understand the answers.

Doctors will ask detailed questions about how your child is feeling and will perform physical examinations. They will also teach you and your child about diabetes and incorporate the recommendations of all the team members into a comprehensive diabetes management plan.

The doctor will lead the other members of the diabetes team in developing an individualized plan for managing diabetes. In addition to monitoring your child for diabetes complications and other medical conditions associated with diabetes, the doctor also will make changes to insulin schedules and write prescriptions for medications and referrals to other specialists as needed.

Certified Diabetes Educators (CDEs)

Certified diabetes educators (CDEs) are nurses, dietitians, social workers, doctors, or pharmacists who help people manage their diabetes. CDEs have had special training to teach parents and kids.

CDEs will:

• explain what diabetes is and how it affects the body
• teach you and your child how to give insulin injections or use an insulin pump
• explain how to treat high and low blood sugar levels
• show you how to adjust medications for exercise and sick days
• demonstrate how to test blood sugar levels, work the blood glucose meter, and test the accuracy of blood sugar monitoring equipment used in the home
• review the diabetes management goals with you
• discuss any challenges you and your child may be facing

Dietitians

Registered dietitians are experts in nutrition and meal planning. They know about food composition and its effects on the body and blood sugar levels. Just as your child grows and develops, so must his or her meal plan, which you can discuss with the dietitian.

Expect the dietitian to track your child's growth and recommend the appropriate amount of calories required each day. The dietitian also will:

• make adjustments to meal plans based on sports, holidays, special events, and other activities
• provide snack and recipe ideas
• teach you and your child how to make healthy food choices
• help you and your child learn carbohydrate counting and meal planning techniques
• teach you to read food labels and develop strategies for determining the carbohydrate content of foods when food labels aren't available

Mental Health Professionals

A mental health professional, usually a social worker or psychologist (but sometimes a psychiatrist or counselor), can be an invaluable resource to families dealing with diabetes, which can be overwhelming.

Mental health professionals can help parents assess any troubles or problems occurring at home, work, or school. They can also monitor how diabetes care is affecting the entire family. In addition, they can help you determine strategies to improve your child's diabetes management.

Social workers also direct you to outside resources (like support groups) that help families with diabetes. They can also suggest ways that families can get necessary diabetes equipment and supplies and help families deal with insurance and financial issues.

Psychologists and psychiatrists can use behavior modification techniques to help kids if they're having difficulty controlling their diabetes, dealing with anger or sadness, or having difficulty taking on the responsibility of caring for their own diabetes as they mature. Psychiatrists can also prescribe medications for emotional problems related to diabetes, such as depression.

Depending on where you live and the type of diabetes facility that you visit (whether it's a specialty diabetes clinic or pediatrician's office), you may find all members of your team in one place. Or you might visit several different offices for diabetes care. If you don't have access to a dietitian or mental health professional but would like to see one, ask the doctor to refer you to one.

Every person on the team is important to managing your child's diabetes, so make sure all of them know the plan so care is as well coordinated as possible.

Reviewed by: Steven Dowshen, MD
Date reviewed: June 2011